Commissioning Infant Feeding Services Part 1

1 Commissioning Infant Feeding Services Part 1 Ensuring every child has the Best Start in Life is one of PHE s national priorities1 Breastfeeding is an important public health priority Supporting families to breastfeed and increasing the number of babies who are breastfed gives babies the best possible start This resource has been developed in partnership between PHE and Unicef UK and is to be read in conjunction with parts 2 and 3 THE BABYFRIENDLYINITIATIVEB reastfeeding in England74% of mothers start to breastfeed244% are breastfeeding at 6 weeks336% are breastfeeding at 6 months4 Only 1% of babies are exclusively breastfed until they are 6 months old5 THE BABYFRIENDLYINITIATIVEThe UK government recommends exclusive breastfeeding for around 6 months and thereafter with other foodsMothers who are young, white, from routine and manual professions and who left education early are least likely to breastfeed6 Breastfeeding benefits the baby from top to toe7,8.

2 9 THE BABYFRIENDLYINITIATIVENOT breastfeeding is linked to an increased risk ofoverweight/obesity later in lifeSudden Infant Death Syndrome (SIDS) ear infections (otitis media)tooth decay & dental malocclusionchest infections (lower respiratory infections)diarrhoea & vomiting (gastroenteritis)death from gut infections in sick and premature babies (nectrotising enterocolitis)There is evidence to suggestthere may be a link between breastfeeding and educational attainmentBreastfeeding supports close and loving relationships which helps the baby s brain developmentMaternal health benefits of breastfeeding10,11,12 Breastfeeding supports close and loving relationships.

3 Improves mental health and can reduce the risk of postnatal depressionThere is good evidence to suggest that breastfeeding decreases the risk ofThere is some evidence to suggest that breastfeeding protects against THE BABYFRIENDLYINITIATIVEO variancancerBreastcancerBreastfeeding reduces overweight and obesityThere is growing evidence linking breastfeeding with protection against later overweight/obesity13 A recent meta-analysis suggests breastfeeding is associated with a 13% reduction in the prevalence of child overweight or obesityChild obesity in England costs approximately 51 million per year and into adulthood, 588-686 million per annum14 THE BABYFRIENDLYINITIATIVEB reastfeeding in a global context Rates of any breastfeeding at 6 months15: Senegal 99% US 49% UK 34%Globally, not breastfeeding is estimated to account for16.

4 823,000 baby deaths a year 20,000 breast cancer deaths in women a year Lower population intelligence which costs society $302 billion annuallyTHE BABYFRIENDLYINITIATIVEThe cost of low breastfeeding rates in England76% of all babies have had formula milk by 6 weeks17 The cost to the NHS every year of treating just 5 illnesses linked to babies not being breastfed is at least 48 million18: ear infection chest infection gut infection necrotising enterocolitis (gut infection in premature babies)

5 Breast cancer76%THE BABYFRIENDLYINITIATIVEB reastfeeding supports families and communities19 THE BABYFRIENDLYINITIATIVEF amilies benefit from the inherent relationshipbuilding that breastfeeding bringsBreastfeeding can help to reduce health inequalities for babies and improve their life chancesBreastfeeding can support family budgets less illness and time off work, feeds babies for significantly lessTHE BABYFRIENDLYINITIATIVEE ight out of ten women stop breastfeeding before they want to and could have continued with more support22 Families live in a culture where formula Feeding is seen as normal and nearly as good as breastfeedingMany English mothers feel unsupported and find breastfeeding very difficult not acceptable in public difficult to combine with work and lifestylesWhy mothers in England don t breastfeedOnly 36% of babies in England20 are receiving

6 Some breastmilk at 6 months compared to 71% of Norwegian babies21 Breastfeeding is seen as normal and supported by everyone in our public Services and in the home, out and about and when returning to work Our ambition for England23,24 SchoolTHE BABYFRIENDLYINITIATIVEWhat needs to be done25,26,27,28 Raise awareness that breastfeeding matters Provide effective professional support to mothers and their families Ensure that mothers have access to support, encouragementand understanding in their community Restrict the promotion of formula milks and baby foodsTHE BABYFRIENDLYINITIATIVER aising awareness that breastfeeding matters 1-2-1 empathetic andmother-centred antenatalconversations with midwivesand health visitorsAntenatal classes, for all parents.

7 That provide holistic approaches to loving and Feeding babiesLocal health promotioncampaigns and education for allBreastfeeding welcomeTHE BABYFRIENDLYINITIATIVEP rovide effective professional support to mothers and their families30,31,32,33 Every maternity unit, health visiting service, neonatal unit and children s centre should be implementingthe Unicef UK Baby Friendly Initiative standards, and ensure that universities are teaching their future health professionals to Unicef UK Baby Friendly standardsTHE BABYFRIENDLYINITIATIVETHE BABYFRIENDLYINITIATIVEE nsure that mothers have access to support in their community34,3 Provide mother to mother support schemes telephone, one-to-one and groups Encourage Welcome to Breastfeed schemes in all public spaces, anywhere, anytime Support employers to implement policies.

8 Practices and environments that support mothers to breastfeed duringstudy and workTHE BABYFRIENDLYINITIATIVER estrict the advertising of formula milks and baby foods36,37,38 All maternity, health visiting, neonatal and children s centre Services should implement the Unicef UK Baby Friendly standardsProhibit advertising in local authority facilitiesSupport your trading standards teams by reporting violations of the UK law in your local areaBuyOURmilk!BuyOURmilk!Buy OUR milk!Buy OUR milk!THE BABYFRIENDLYINITIATIVETHE BABYFRIENDLYINITIATIVE1.

9 PHE (2014) Evidence into Action: Opportunities to Protect and Improve the Nation s Health. In England, 2014-15, NHS England (2015) Statistical Release Breastfeeding Initiation & Breastfeeding Prevalence 6-8 weeks. 2nd July. In England, 2014-15, NHS England (2015) Statistical Release Breastfeeding Initiation & Breastfeeding Prevalence 6-8 weeks. 2nd July. In 2010 in England, McAndrew F, Thompson J, Fellows L, Large A, Speed M, Renfrew MJ (2012) Infant Feeding Survey 2010, Health and Social Care Information Centre In 2010 in England, McAndrew F, Thompson J, Fellows L, Large A, Speed M, Renfrew MJ (2012) Infant Feeding Survey 2010, Health and Social Care Information Centre Davies, S (2014) Annual Report of the Chief Medical Officer 2014, The Health of the 51%.

10 Women Victora CG, Bahl R, Barros AJD, Franca GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC (2016) Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet Series: Breastfeeding 1. Volume 387, No. 10017, p475 490, 30 Acta Paediatrica (2015) Special Issue: Impact of Breastfeeding on Maternal and Child Health, December, Volume 104, Issue Supplement S467, Pages 1 Hansen K (2016) Breastfeeding: a smart investment in people and in economics, The Lancet.